Drug & supplement interaction

Indian Snakeroot + Siponimod

Siponimod brand name: Mayzent.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Indian Snakeroot and Siponimod in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Indian Snakeroot and Siponimod

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Siponimod and Indian Snakeroot in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Indian Snakeroot safety at a glance

Indian Snakeroot overall Use caution Contains potent alkaloids that can cause serious side effects and should only be used under medical supervision.
Pregnancy Avoid Avoid during pregnancy, as its alkaloids may harm the developing baby.
Breastfeeding Avoid Avoid while breastfeeding, since reserpine can pass into breast milk.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Siponimod and Indian Snakeroot? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Siponimod

Interactions in our licensed database are recorded against drug classes, not just single drug names. Siponimod is filed under 4 classifications — including cytochrome p450 2c9 (cyp2c9) substrates, immunosuppressants, cytochrome p450 3a4 (cyp3a4) substrates. Indian Snakeroot has documented interactions with 13 drug classes — the most serious being antipsychotic drugs (major), beta-blockers (major) and digoxin (lanoxin) (major) — and none of Siponimod’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Indian Snakeroot Does Interact With Other Medications

Indian Snakeroot has 83 major, 760 moderate known drug interactions in our database — Siponimod isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Indian Snakeroot

Covers the 2,830 medications we’ve checked against Indian Snakeroot. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Indian Snakeroot and Siponimod May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 5 of them are worth acting on rather than waiting out — marked below.

  • A slow heartbeat Worth acting on Additional detail

    Indian Snakeroot

    “Orally, Indian snakeroot has been associated with reports of bradycardia and mild hypotension. These adverse effects are thought to be related to the constituent reserpine. Adverse reactions to reserpine also include angina-like symptoms.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in angina.

    6 sources cited
    1. 94331. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.
    2. 94440. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. N Engl J Med. 1953 Jan 8;248(2):48-53.
    3. 94328. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.
    4. 3312. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
    5. 17465. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
    6. 86801. Giampreti, A., Lonati, D., Locatelli, C., Rocchi, L., and Campailla, M. T. Acute neurotoxicity after yohimbine ingestion by a body builder. Clin Toxicol.(Phila) 2009;47(8):827-829. PubMed

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

  • Seizures Worth acting on Additional detail

    Indian Snakeroot

    “Orally, Indian snakeroot may cause headaches, feeling cold, dizziness, drowsiness, nightmares, and mild sedation. Indian snakeroot contains small amounts of reserpine and yohimbine and may theoretically cause some of the adverse effects associated with these constituents. Doses of reserpine of greater than 0.5 mg daily can increase the risk of side effects.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 94331. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.
    2. 94332. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
    3. 94438. Achor RW, Hanson NO, Gifford RW Jr. Hypertension treated with Rauwolfia serpentina (whole root) and with reserpine; controlled study disclosing occasional severe depression. J Am Med Assoc. 1955 Oct 29;159(9):841-5. PubMed
    4. 94440. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. N Engl J Med. 1953 Jan 8;248(2):48-53.
    5. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    6. 94328. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

  • Raised blood pressure Worth acting on Additional detail

    Indian Snakeroot

    Recorded for Indian Snakeroot in the same Natural Medicines adverse-effect record shown under A slow heartbeat above.

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

  • A low white blood cell count Worth acting on Additional detail

    Indian Snakeroot

    “Indian snakeroot contains small amounts of reserpine and yohimbine and may theoretically cause some of the adverse effects associated with these constituents. A case of drug-induced agranulocytosis has been reported following prolonged use of oral yohimbine. Reserpine may cause thrombocytopenia.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    2 sources cited
    1. 86877. Siddiqui, M. A., More-O'Ferrall, D., Hammod, R. S., Baime, R. V., and Staddon, A. P. Agranulocytosis associated with yohimbine use. Arch.Intern.Med 6-10-1996;156(11):1235-1237.
    2. 275. Young DS. Effects of Drugs on Clinical Laboratory Tests 4th ed. Washington: AACC Press, 1995.

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

  • An allergic reaction Worth acting on Additional detail

    Indian Snakeroot

    “Orally, Indian snakeroot can cause nasal stuffiness or congestion and shortness of breath. One study shows that Indian snakeroot may increase the risk for nasal congestion more than the constituent reserpine.. Reserpine is also associated with rare reports of allergic reactions that can precipitate asthma (15,94328).”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in asthma.

    6 sources cited
    1. 94330. Lowinger P. Rauwolfia serpentina in the control of anxiety. Psychiatr Q. 1957 Jul;31(3):445-53. PubMed
    2. 94332. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
    3. 94438. Achor RW, Hanson NO, Gifford RW Jr. Hypertension treated with Rauwolfia serpentina (whole root) and with reserpine; controlled study disclosing occasional severe depression. J Am Med Assoc. 1955 Oct 29;159(9):841-5. PubMed
    4. 94440. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. N Engl J Med. 1953 Jan 8;248(2):48-53.
    5. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    6. 94328. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.

    “There is one report of a hypersensitivity reaction to yohimbine, a constituent of Indian snakeroot. Symptoms included fever, chills, malaise, itchy, scaly skin, progressive kidney failure, and a lupus-like syndrome.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in kidney failure.

    1 source cited
    1. 6169. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

  • Tiredness Additional detail

    Indian Snakeroot

    Recorded for Indian Snakeroot in the same Natural Medicines adverse-effect record shown under An allergic reaction above.

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

  • Dizziness / Headache Additional detail

    Indian Snakeroot

    Recorded for Indian Snakeroot in the same Natural Medicines adverse-effect record shown under Seizures above.

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

  • Diarrhea Additional detail

    Indian Snakeroot

    “Orally, Indian snakeroot has been associated with increased or decreased appetite, diarrhea, nausea, vomiting, and abdominal pain. Yohimbine, a constituent of Indian snakeroot, has been associated with nausea, vomiting, increased salivation, diarrhea, and gastrointestinal distress. Reserpine, another constituent of Indian snakeroot, may cause gastrointestinal irritation and activation of peptic ulcers (15,19).”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 94332. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
    2. 94438. Achor RW, Hanson NO, Gifford RW Jr. Hypertension treated with Rauwolfia serpentina (whole root) and with reserpine; controlled study disclosing occasional severe depression. J Am Med Assoc. 1955 Oct 29;159(9):841-5. PubMed
    3. 94440. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. N Engl J Med. 1953 Jan 8;248(2):48-53.
    4. 3970. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
    5. 17465. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
    6. 86780. Bagheri, H., Schmitt, L., Berlan, M., and Montastruc, J. L. Effect of 3 weeks treatment with yohimbine on salivary secretion in healthy volunteers and in depressed patients treated with tricyclic antidepressants. Br J Clin Pharmacol 1992;34(6):555-558. PubMed

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

  • A skin rash Additional detail

    Indian Snakeroot

    “Indian snakeroot contains small amounts of reserpine and yohimbine and may theoretically cause some of the adverse effects associated with these constituents. Orally, reserpine can cause facial flushing, skin rash, and itching. Yohimbine may cause rash, erythrodermic skin eruption, and exanthema.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in pruritus.

    5 sources cited
    1. 94328. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.
    2. 3312. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
    3. 3971. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
    4. 86878. Mann, K., Klingler, T., Noe, S., Roschke, J., Muller, S., and Benkert, O. Effects of yohimbine on sexual experiences and nocturnal penile tumescence and rigidity in erectile dysfunction. Arch.Sex Behav. 1996;25(1):1-16. PubMed
    5. 86896. Riley AJ, Goodman R, Kellett JM, and et al. Double blind trial of yohimbine hydrochloride in the treatment of erection inadequacy. Sexual Marital Ther 1989;4(1):17-26. DOI

    Siponimod

    Listed in the ADVERSE REACTIONS section of the FDA label for Siponimod. Read the label on DailyMed ›

Showing the 10 most notable of 11 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Indian Snakeroot but not commonly for Siponimod: stomach upset, fainting, a heart attack and an irregular heartbeat.

Effects for Siponimod come from the ADVERSE REACTIONS section of its FDA label; effects for Indian Snakeroot come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Siponimod

This page covers Indian Snakeroot only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Siponimod page lists 190 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 147 moderate · 40 minor.

From our pharmacist’s overview on the Siponimod page

“Siponimod (Mayzent) treats secondary progressive multiple sclerosis, and because its blood level depends heavily on two liver enzymes, this is a supplement list to respect. Most of these entries can nudge siponimod levels up or down; the three rated major are grapefruit, which raises them, St.”

Reviewed by 2 · Jul 18, 2026

Open the Siponimod interaction page

One more smart check

Taking Indian Snakeroot as Part of a Dietary Supplement Product? Check It for Interactions

We hold 70 real supplement products containing Indian Snakeroot, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indian Snakeroot. Even though Indian Snakeroot itself has no known interaction with Siponimod, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Indian Snakeroot and Siponimod Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Indian Snakeroot
Top half

#609 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Siponimod
Steady interest

#1,973 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Indian Snakeroot reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Indian Snakeroot and Siponimod records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Indian Snakeroot

What is Indian Snakeroot?

Indian Snakeroot
  • High blood pressure
  • Anxiety and stress
  • Insomnia
  • Agitation
  • Fever (traditional use)

Indian snakeroot is a traditional Ayurvedic plant that contains reserpine, a compound with real blood-pressure-lowering and sedative effects. Because its potent alkaloids can cause serious side effects like depression and very low blood pressure, it should never be used without medical supervision. It is not a safe or simple home remedy, and many countries restrict its use.

Rauvolfia serpentina · Apocynaceae · Root · Powder, capsules, tablets, dried root, traditional preparations

An interaction check asks whether these two react with each other — it does not ask whether Indian Snakeroot is a good idea for someone in your situation. Here is what our Indian Snakeroot record says about it on its own.

Indian Snakeroot: dosing

There is no well-established safe dose of Indian snakeroot for self-care. The amount of active alkaloids in herbal products can vary widely, which makes safe dosing difficult.If a healthcare provider recommends a product, follow the label and their instructions exactly. Do not increase the dose on your own.

From our Indian Snakeroot monograph — the full record covers uses, side effects and every documented interaction.

Read the full Indian Snakeroot monograph & all interactions
Medication

About Siponimod

What Is Siponimod Used For?

Brand name: Mayzent

Mayzent (siponimod) is approved for adults with relapsing forms of multiple sclerosis (MS). This includes three specific types: clinically isolated syndrome (a first episode of MS-like symptoms), relapsing-remitting MS (periods of attacks followed by recovery), and active secondary progressive MS (a phase where the disease gradually worsens but still has active relapses).

It is taken by mouth once daily and is intended as a long-term treatment to reduce relapses and slow disease progression.

Most-Reported Side Effects for Siponimod

From FAERS, the FDA’s public side-effect reporting system (8,869 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fatigue 993 reports
Headache 890 reports
Dizziness 671 reports
Multiple sclerosis relapse 546 reports
Gait disturbance 537 reports
See full Siponimod drug information
Keep checking

Other Drugs & Indian Snakeroot

Browse every other medication we’ve checked against Indian Snakeroot — both the ones with a known interaction and the ones without. Select any drug for the full detail.

83Major
760Moderate
0Minor
1,986No known interaction
Major

83 interactions

Showing 60 of 83 major interactions — see all 83 on the Indian Snakeroot page.

Moderate

760 interactions

Showing 60 of 760 moderate interactions — see all 760 on the Indian Snakeroot page.

No interaction 1,986 drugs checked — show the list
Evidence & sources

Indian Snakeroot References

The 43 references that drive our Indian Snakeroot monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  5. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  6. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  7. Young DS. Effects of Drugs on Clinical Laboratory Tests 4th ed. Washington: AACC Press, 1995.
  8. Milman N, Scheibel J, Jessen O. Lysine prophylaxis in recurrent herpes simplex labialis: a double-blind, controlled crossover study. Acta Derm Venereol 1980;60:85-7.
  9. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
  10. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
  11. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
  12. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed
  13. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
  14. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
  15. Mustonen, P., Savola, J., and Lassila, R. Atipamezole, an imidazoline-type alpha(2)-adrenoceptor inhibitor, binds to human platelets and inhibits their adrenaline-induced aggregation more effectively than yohimbine. Thromb.Res 8-1-2000;99(3):231-237.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Indian Snakeroot and Siponimod Together: Common Questions

Is it safe to take Indian Snakeroot with Siponimod?
We do not list a known interaction between Indian Snakeroot and Siponimod. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Indian Snakeroot and Siponimod have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Indian Snakeroot and Siponimod combination checked?
Interactions in our licensed database are recorded against drug classes. Siponimod is filed under 4 classifications, and Indian Snakeroot has documented interactions with 13 drug classes — none of Siponimod's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Indian Snakeroot interact with any other medications?
Yes. Indian Snakeroot has 843 documented drug interactions in our database — Siponimod is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Siponimod interact with any supplements?
Yes. Siponimod has documented interactions with 190 supplements in our database — Indian Snakeroot is not one of them. The Siponimod interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Siponimod and Indian Snakeroot?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.